CHIME Members Testify During Federal Hearing on Implementation and Usability

July 23, 2013

Four members of the College of Healthcare Information Management Executives (CHIME) testified before federal officials today, calling for safe, orderly transition to Meaningful Use Stage 2 that leaves no one behind.

During a joint hearing in front of two Federal Advisory Committees in Washington, D.C., CIOs representing facilities in Kentucky, Pennsylvania, Texas and Virginia spoke to officials on Meaningful Use Stage 1 implementation, Stage 2 readiness, and Stage 3 proposed policies. Believing Stage 1 had accomplished great strides in electronic health record (EHR) adoption, the panel of CIOs highlighted common challenges surrounding Stage 2. Specifically, they identified objectives related to transitions of care, patient portals, and clinical quality measures (CQMs) as posing the greatest challenges for their organizations.

“All of the objectives listed as challenges require significant work to implement after upgrading to 2014 certified software,” said Pamela McNutt, Sr. Vice President and CIO at Dallas-based Methodist Health System. “For example, after delivery of the patient portal we will have to map data elements from the patient record and clinical staff will need to ensure that the data is representing accurately.”

McNutt added that sacrificing accuracy for speed presents significant concerns in terms of the timeline to demonstrate 100 percent compliance of Stage 2 by July 1, 2014 for eligible hospitals (EHs).

Tom Pagano, CIO at HCA Capital Division in Richmond, and Rodney Dykehouse, CIO at Penn State Hershey Medical Center and College of Medicine, further explained that vendors are forced into selecting a specific workflow to certify, and providers often find they must either ask for modifications to their reporting logic, or completely change an existing (embedded) workflow.

“We’re not opposed to changing workflow if it is a better workflow, but we are opposed to changing a workflow only to ‘prove’ that we’re meeting the intent of the requirement,” Dykehouse said.

Current adoption trends for EHRs are promising, with nearly 79 percent of all eligible hospitals (EHs) and over 55 percent of eligible professionals (EPs) having received an EHR incentive payment under Medicare or Medicaid since 2011. However, the structure of the incentives program has created a timing crunch in 2014 when over 500,000 hospitals and physicians are required to upgrade their existing technology to demonstrate meaningful use.

“The difficultly in achieving meaningful use, beyond the new, more complex objectives, is compounded by the short timeframes allowed for hospitals to implement 2014 certified EHRs.” said Randy McCleese, vice president of Information Systems and CIO at St. Claire Regional Medical Center in Morehead, KY.

To alleviate this short timeframe, CHIME recently called for an extension of Stage 2 to ensure momentum towards widespread adoption of EHRs was maintained; flexibility was granted to hospitals and physicians striving towards meeting program requirements of their respective stage; and policymakers had time to assess and evaluate programmatic trends needed to craft thoughtful Stage 3 rules.

“The EHR Medicare and Medicaid Incentive program has played a major role in advancing the adoption of health IT in the US, yet certain changes are needed to assure this initiative enables improvements in care quality, increases affordability, and improves healthcare outcomes,” said CHIME President and CEO Russell P. Branzell. “To accomplish these goals, CHIME strongly encourages HHS to amend existing timelines for 2014, thus promoting a safe, orderly transition to Stage 2 that leaves no one behind.”